Information

  • Document No.

  • Trader

  • Conducted on

  • Address
  • Inspector

Instrument info

  • Select Applicable

  • Appliance

  • Instrument Details

  • Capacity

  • Specify Capacity

  • Tested as Correct

Data input

Pre-packaged Goods

  • Pre-packaged Goods

  • Pre-packaged Item
  • Goods

  • Number examined

  • Compliance

  • Supplier

  • Stated Net Quantity

  • Tare, if able to be determined

  • Gross Weights (Aim for minimum sample of 12 packages)

  • Batch Code/ Use by Date:

  • Price

  • Units sold weekly

  • Add media

Catchweight Goods

  • CatchWeight Goods

  • Catchweight Item
  • Goods

  • Number examined

  • Compliance

  • Supplier

  • When goods are non-complying, list non-complying goods in order, details below:

    e.g.
    Gross: 355g 760g 920g
    Tare: 10g
    Stated: 355g 760g 920g
    Actual: 345g 750g 910g

  • Gross Weight Quantities

  • Packaging Tare Weight

  • Stated Net Quantities

  • Actual Net Quantity

  • Batch Code/ Use by Date:

  • Price

  • Units sold weekly

  • Take Photo of Non-Compliance

Acknowledgement of Report

  • Signature of Trader Acknowledging Information Received

  • Traders Signature

  • Select date

  • Inspectors Signature

  • Reminder to click 'Save' once signature and date has been attained

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.